Digital device comparable to analog in duration of pleural drainage, hospital stay

SEATTLE — Digital pleural drainage devices did not significantly reduce the time of chest tube drainage or hospital stays in patients with or without a pulmonary air leak after lung resection when compared with analog drainage methods, according to data presented at the American Association for Thoracic Surgery Annual Meeting.

“We observed no difference in the primary outcome between patients randomized to analog or digital pleural drainage regardless of postoperative air leak status,” Sebastien Gilbert, MD, FRCSC, of the University of Ottawa, said. “Based on the results, we do not recommend the use of a digital pleural drainage device as an intervention to reduce length of stay after elective pulmonary resection.”

Sebastien Gilbert

Gilbert and colleagues conducted a controlled, open-label, parallel-group trial on 172 patients undergoing lung resection to analyze the impact digital pleural drainage devices had on time to chest tube removal and length of hospital stay after surgery. A protocol that included fluid output equal to or less than 250 mL daily and the absence of an air leak as removal criteria was used to manage chest drains.

In the no air leak (n = 87) and air leak (n = 85) groups, patient factors and operative details were comparable between analog and digital groups except for a higher median forced expiratory volume in 1 second percentage in digital drainage patients without an air leak. In patients without an air leak, there was minimal difference in the median time of drainage (analog, 3 days vs. digital, 2.9 days; P = .05) and length of hospital stay (analog, 4.3 days vs. digital, 4 days).

Among patients with an air leak, the results were nearly identical for the median time of chest tube drainage (analog, 5.6 days vs. digital, 4.9 days). The median length of hospital stay was 6.2 days for both the analog and digital drainage devices.

Gilbert said the lack of clinician inexperience in using the digital technology warrants more research for these and other devices.

“There may be opportunities to improve efficiency in chest tube management with more reliable monitoring of air leak flow and a potential decrease in need of chest tube clamping trials,” he said. “I also think there may be clinically relevant knowledge to be gained from the analysis of the data stream provided by digital devices.” – by Ryan McDonald

Reference:

Gilbert S, et al. Plenary 3. Presented at: the American Association for Thoracic Surgery Annual Meeting; April 25-29, 2015; Seattle.

Disclosure: Gilbert reports that Medela provided a discounted rate for devices used in the procedure.